NPI | 1902945991 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA 20A11334) |
Additional Taxonomies | 208000000X Pediatrics (Licence: CO 46862) |
Enumeration Date | 2007-02-06 |
Last Update Date | 2015-05-15 |